Research article - (2012)11, 709 - 718
Magnetic Versus Electrical Stimulation in the Interpolation Twitch Technique of Elbow Flexors
Sofia I. Lampropoulou, Alexander V. Nowicky, Louise Marston
School of Health Sciences and Social Care, Centre for Rehabilitation Research, Brunel University, Uxbridge, UK

Sofia I. Lampropoulou
✉ Physiotherapy Department, Technological Educational Institute (T.E.I.) of Patras, Branch Department of Aigion, 6 Psaron Street Aigion, 25100, Greece
Email: sofia.lampropoulou@yahoo.co.uk
Received: 15-07-2012 -- Accepted: 24-09-2012
Published (online): 01-12-2012

ABSTRACT

The study compared peripheral magnetic with electrical stimulation of the biceps brachii m. (BB) in the single pulse Interpolation Twitch Technique (ITT). 14 healthy participants (31±7 years) participated in a within-subjects repeated-measures design study. Single, constant-current electrical and magnetic stimuli were delivered over the motor point of BB with supramaximal intensity (20% above maximum) at rest and at various levels of voluntary contraction. Force measurements from right elbow isometric flexion and muscle electromyograms (EMG) from the BB, the triceps brachii m. (TB) and the abductor pollicis brevis m. (APB) were obtained. The twitch forces at rest and maximal contractions, the twitch force-voluntary force relationship, the M-waves and the voluntary activation (VA) of BB between magnetic and electrical stimulation were compared. The mean amplitude of the twitches evoked at MVC was not significantly different between electrical (0.62 ± 0.49 N) and magnetic (0.81 ± 0.49 N) stimulation (p > 0.05), and the maximum VA of BB was comparable between electrical (95%) and magnetic (93%) stimulation (p > 0. 05). No differences (p >0.05) were revealed in the BB M-waves between electrical (13.47 ± 0.49 mV.ms) and magnetic (12.61 ± 0.58 mV.ms) stimulation. The TB M-waves were also similar (p > 0.05) but electrically evoked APB M-waves were significantly larger than those evoked by magnetic stimulation (p < 0.05). The twitch-voluntary force relationship over the range of MVCs was best described by non-linear functions for both electrical and magnetic stimulation. The electrically evoked resting twitches were consistently larger in amplitude than the magnetically evoked ones (mean difference 3.1 ± 3.34 N, p < 0.05). Reduction of the inter-electrodes distance reduced the twitch amplitude by 6.5 ± 6.2 N (p < 0.05). The fundamental similarities in voluntary activation assessment of BB with peripheral electrical and magnetic stimulation point towards a promising new application of peripheral magnetic stimulation as an alternative to the conventional ITT for the assessment of BB voluntary activation.

Key words: Electrical stimulation, magnetic stimulation, interpolation twitch technique, voluntary activation, elbow flexors.

Key Points
  • The study compared peripheral electrical and magnetic stimulation in the assessment of voluntary activation using single pulse twitch interpolation of elbow flexors.
  • Key similarities between magnetic and electrical stimulation in the assessment of voluntary activation with the single pulse Interpolation Twitch Technique were revealed.
  • Voluntary activation at maximal contractions were similar for the two methods of stimulation and the twitch-voluntary force best fit with nonlinear functions for both magnetic and electrical stimulation.
  • The fundamental similarities in voluntary activation assessment of elbow flexor, m. Biceps Brachii with these two methods of stimulation support the application of peripheral magnetic stimulation using the conventional Interpolation Twitch Technique.
  • The painless assessment of voluntary activation with peripheral magnetic stimulation may strengthen its acceptance for clinical use in neuromuscular assessment.








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